Systematic Review Of Evidence Research Articles

Experiences of accessing mental health services for women living on a low income in Canada: a qualitative systematic review protocol.

The objective of this review is to comprehensively analyze qualitative evidence on the experiences of Canadian women aged 18 years or above living on a low income. The review will examine the intersectionality of their identities and privileges when accessing mental health services, with the aim of informing targeted interventions and policy improvements. Despite the growing body of research on mental health disparities and a call for improved mental health care, both globally and in Canada, there is a need to identify recommendations for system enhancement and to improve gender equality by understanding the nuanced experiences of accessing mental health care for Canadian women living on a low income. This review will include qualitative studies conducted within the past decade about women of diverse backgrounds aged 18 years or above who identify as living on a low income and who have resided in Canada for 6 months or longer. Studies using any qualitative methodology will be included. The following databases will be searched for published studies: MEDLINE and PsycINFO (Ovid); CINAHL and Pre-CINAHL (EBSCOhost); LiSSa; and Google Scholar. Searches for unpublished studies will include the Primo Central Index, ProQuest Dissertations and Theses Global, and the Canadian Women's Foundation Studies. The review will include studies published in English and French in Canada, from 2013 to the present. The JBI methodology for systematic reviews of qualitative evidence will be followed, informing study selection, appraisal, extraction, synthesis, and assessment of confidence, which will be conducted by 2 independent reviewers. PROSPERO CRD42023430100.

Experiences of parents of teenagers with life-threatening food allergies: a qualitative systematic review protocol.

The objective of this review is to synthesize the experiences of parents of teenagers with life-threatening food allergies. Life-threatening food allergies are increasing globally, with a significant effect on families, particularly parents. The teenage years are a time of increasing autonomy for young people; however, for parents living with and caring for a teenager with a life-threatening food allergy, this responsibility can have a considerable impact. This review will include qualitative studies on the experiences of parents of teenagers with life-threatening food allergies, including, but not limited to, caregiving, parenting, and psychosocial experiences; any day-to-day activities, happenings, thoughts, or feelings related to parenting a teenager with life-threatening food allergies; and the handing over of responsibility for the allergy to the teenager. The review will include studies on participants in the community and in health care settings such as inpatient hospitalizations, outpatient visits, school and sports events, family dinners, restaurants, and travel. Participants from all cultural backgrounds, socio-economic backgrounds, and countries will be included. The review will follow the JBI methodology for systematic reviews of qualitative evidence. The search for published studies will include CINAHL, MEDLINE, and PsycINFO (EBSCOhost); Embase (Ovid); LILACS, IBSS, and Sociological Abstracts (ProQuest). The search for unpublished studies will include ProQuest Dissertations and Theses, Open Access Theses and Dissertations (OATD), Bielefeld Academic Search Engine (BASE), Google, and Google Scholar. Databases will be searched from inception until the present. JBI tools and guidelines will be used to conduct critical appraisal, data extraction, data synthesis, and assessment of confidence in the findings. PROSPERO CRD42024503698.

Multiple myeloma refractory to lenalidomide: A systematic literature review of trials and real-world evidence.

The growing use of frontline lenalidomide treatment in multiple myeloma (MM) is increasing the proportion of lenalidomide-refractory patients, which may limit the efficacy of subsequent lines of treatment (LOT). This systematic literature review (January 2008-October 2023) of clinical trials (CT) and real-world studies (RW) assessed treatment outcomes in adults with relapsed/refractory MM (RRMM) who were previously treated with ≥1 LOT, progressed and were lenalidomide-refractory. Medline, EMBASE and additional electronic databases were searched for articles published in English. Primary outcomes included progression-free survival (PFS), overall survival (OS) and overall/objective response rate (ORR); 24 CT and 19 RW were included. For CT, the population-weighted mean of median PFS (CT = 14) and OS (CT = 6) were shorter in the lenalidomide-refractory cohort (months: 8.8 [n = 2699] and 21.7 [n = 1066], respectively) than the intent-to-treat population (months: 13.8 [n = 5380] and 35.9 [n = 2264], respectively); the population-weighted (N = 2142) mean ORR for lenalidomide-refractory patients (CT = 18) was 56.0%. RW reported considerable variation in PFS (RW = 7), OS (RW = 8) and ORR (RW = 8); and median PFS (RW = 2; months) was lower in lenalidomide/bortezomib-refractory (5.5/5.5; n = 81/n = 25) versus lenalidomide-refractory (7.3/8.0; n = 81/n = 61) patients. These data provide evidence that clinical trials and real-world outcomes are suboptimal in lenalidomide-refractory patients with RRMM, highlighting the need to improve treatment options for this population.

Defensive healthcare practice: systematic review of qualitative evidence

ObjectiveTo synthesise qualitative evidence on clinicians’ views and experiences of defensive practice.DesignSystematic review of qualitative data.Data sourcesMEDLINE, Embase, PsycINFO, AMED, Maternity and Infant Care, CINAHL, ASSIA, Sociological s, Proquest Dissertations...

Involving different stakeholders in prioritising outcomes to assess healthcare systems response for type 1 diabetes management: Using co-creation approaches in Peru.

Engaging diverse stakeholders in developing core outcome sets (COSs) can produce more meaningful metrics as well as research responsive to patient needs. The most common COS prioritisation method, Delphi surveys, has limitations related to selection bias and participant understanding, while qualitative methods like group discussions are less frequently used. This study aims to test a co-creation approach to COS development for type 1 diabetes (T1DM) in Peru. Using a co-creation approach, we aimed to prioritise outcomes for T1DM management in Peru, incorporating perspectives from people with T1DM, caregivers, healthcare professionals, and decision-makers. A set of outcomes were previously identified through a systematic review and qualitative evidence synthesis. Through qualitative descriptive methods, including in-person workshops, each group of stakeholders contributed to the ranking of outcomes. Decision-makers also discussed the feasibility of measuring these outcomes within the Peruvian healthcare system. While priorities varied among participant groups, all underscored the significance of monitoring healthcare system functionality over mortality. Participants recognized the interconnected nature of healthcare system performance, clinical outcomes, self-management, and quality of life. When combining the rankings from all the groups, metrics related to economic impact on the individual and structural support, policies promoting health, and protecting those living with T1DM were deemed more important in comparison to measuring clinical outcomes. We present the first COS for T1DM focused on low-and-middle-income countriesand show aspects of care that are relevant in this setting. Diverse prioritisation among participant groups underscores the need of inclusive decision-making processes. By incorporating varied perspectives, healthcare systems can better address patient needs and enhance overall care quality.

Epidemiology of Trichomonas vaginalis infection in the Middle East and North Africa: systematic review, meta-analyses, and meta-regressions

Trichomoniasis, caused by the parasite Trichomonas vaginalis (TV), remains an underappreciated sexually transmitted infection (STI), primarily due to inadequate understanding of its epidemiology and public health implications. This study aimed to characterize TV epidemiology in the Middle East and North Africa (MENA). Systematic review and analysis of evidence sourced from international, regional, and national databases were conducted. Findings were reported following PRISMA guidelines. Random-effects meta-analyses and meta-regressions were performed to determine pooled mean prevalence, investigate associations with prevalence, and identify sources of between-study heterogeneity. The review identified 263 relevant publications, encompassing 462TV prevalence measures. The pooled mean TV prevalence was estimated as follows: 4.7% (95% CI: 3.9-5.6%) in the general population of women, 17.2%(95% CI: 5.4-33.6%) among intermediate-risk populations, 10.3% (95% CI: 6.2-15.3%) among female sex workers, 13.9% (95% CI: 12.3-15.6%) among symptomatic women, 7.4% (95% CI: 1.9-15.5%) among infertility clinic attendees, 2.3% (95% CI: 0.1-6.3%) among women with miscarriages or ectopic pregnancies, and 1.6%(95% CI: 0.8-2.7%) among STI clinic attendees. Limited data were found for men. Multivariable meta-regressions explained >40% of the prevalence variation, unveiling a hierarchical prevalence pattern by population type, an inverse correlation with national income, and a prevalence decline at a rate of 1% per calendar year. Despite conservative sexual norms, MENA has a substantial TV prevalence, comparable to the global TV prevalence. The unexpectedly high prevalence of this curable infection may, in part, be attributed to limited access to and underutilization of STI screening and treatment services. This work was supported by the Qatar Research, Development, and Innovation Council [ARG01-0522-230273] and by the Biomedical Research Program at Weill Cornell Medicine-Qatar.

Multiorgan manifestations of COL4A1 and COL4A2 variants and proposal for a clinical management protocol.

COL4A1/2 variants are associated with highly variable multiorgan manifestations. Depicting the whole clinical spectrum of COL4A1/2-related manifestations is challenging, and there is no consensus on management and preventative strategies. Based on a systematic review of current evidence on COL4A1/2-related disease, we developed a clinical questionnaire that we administered to 43 individuals from 23 distinct families carrying pathogenic variants. In this cohort, we extended ophthalmological and cardiological examinations to asymptomatic individuals and those with only limited or mild, often nonspecific, clinical signs commonly occurring in the general population (i.e., oligosymptomatic). The most frequent clinical findings emerging from both the literature review and the questionnaire included stroke (203/685, 29.6%), seizures or epilepsy (199/685, 29.0%), intellectual disability or developmental delay (168/685, 24.5%), porencephaly/schizencephaly (168/685, 24.5%), motor impairment (162/685, 23.6%), cataract (124/685, 18.1%), hematuria (63/685, 9.2%), and retinal arterial tortuosity (58/685, 8.5%). In oligosymptomatic and asymptomatic carriers, ophthalmological investigations detected retinal vascular tortuosity (5/13, 38.5%), dysgenesis of the anterior segment (4/13, 30.8%), and cataract (2/13, 15.4%), while cardiological investigations were unremarkable except for mild ascending aortic ectasia in 1/8 (12.5%). Our multimodal approach confirms highly variable penetrance and expressivity in COL4A1/2-related conditions, even at the intrafamilial level with neurological involvement being the most frequent and severe finding in both children and adults. We propose a protocol for prevention and management based on individualized risk estimation and periodic multiorgan evaluations.

Effectiveness of community-based interventions for prevention and control of hypertension in sub-Saharan Africa: A systematic review.

Hypertension poses a significant public health challenge in sub-Saharan Africa due to various risk factors. Community-based intervention for prevention and control of hypertension is an effective strategy to minimize the negative health outcomes. However, comprehensive systematic review evidence to inform effective community-based interventions for prevention and control of hypertension in low resource settings is lacking. This study aimed to synthesize the effectiveness of community-based interventions on prevention and control of hypertension in sub-Saharan Africa. A comprehensive search for studies was carried out on PubMed, CINAHL, Web of Science Core Collection, Embase, Scopus, and Google scholar databases. The result of the review was reported according to PRISMA guidelines. Studies published in English language were included. Two independent reviewers conducted critical appraisal of included studies and extracted the data using predefined excel sheet. Experimental, quasi experimental, cohort and analytical cross-sectional studies conducted on adults who have received community-based interventions for prevention and controls of hypertension in sub-Saharan Africa were included. In this systematic review, a total of eight studies were included, comprising of two interventional studies, two quasi-experimental studies, three cohort studies, and one comparative cross-sectional study. The interventions included health education, health promotion, home-based screening and diagnosis, as well as referral and treatment of hypertensive patients. The sample sizes ranged from 236 to 13,412 in the intervention group and 346 to 6,398 in the control group. This systematic review shows the effect of community-based interventions on reduction of systolic and diastolic blood pressure. However, the existing evidence is inconsistence and not strong enough to synthesize the effect of community-based interventions for the prevention and control of hypertension in sub-Saharan Africa. Hence, further primary studies need on the effect of community-based interventions for the prevention and control of hypertension in sub-Saharan Africa. Systematic review registration number: PROSPERO CRD42022342823.

Systematic review and meta-analysis of current evidences in endograft therapy vs. medical treatment for Spontaneous Isolated Superior Mesenteric Artery Dissection.

Endovascular stent therapy (EST) for spontaneous isolated superior mesenteric artery dissection (SISMAD) is gaining popularity, yet the treatment strategy - BMT or EST - remains debatable. A meta-analysis examined all randomized trials and observational studies exploring the relative merits and potential risks of EST vs. BMT in treating SISMAD patients. Key outcomes included early and long-term adverse effects, with odds ratios (ORs) and 95% confidence intervals (CI) calculated. A random- or fixed-effects model was selected according to a 50% heterogeneity threshold. 9 observational studies involving a total of 672 SISMAD patients (303 EST), met our selection criteria. We discovered no noteworthy distinctions between the EST group and the BMT group in terms of early symptoms' alleviation, reinterventions, or all-cause mortality. However, patients receiving EST management will be hospitalized longer than those receiving BMT (EST: 13.2 ± 5.1 months vs. BMT: 7.0 ± 2.2 months, P < 0.01). In the long run, EST was found to significantly contribute to a higher rate of complete remodeling (OR: 4.53, CI: 3.01 ~ 6.81, P < 0.01; heterogeneity, I2 = 50%) and a lower incidence of aneurysm formation (OR: 0.19, CI: 0.06 ~ 0.6, P < 0.01; heterogeneity, I2 = 0%) than BMT. However, there are no significant differences between ESTand BMTin terms of all-cause mortality, recurrent syndrome, reintervention, and SMA stenosis or occlusion. EST can effectively prevent the formation of aneurysmal dissection and improve SISMAD remodeling. Both EST and BMT are similar in reducing long-term mortality, recurrent symptoms, severe SMA stenosis or occlusion, and the need for reintervention in patients with SISMAD.

Cold city outdoor space utilisation patterns and constraints: A systematic review of empirical evidence

Urban outdoor spaces, as significant venues for outdoor activities, are closely linked to urban residents' quality of life and physical health. However, evidence suggests that prolonged and cold winters in cold cities, characterised by low temperatures, ice and snow, and frigid winds, profoundly impact residents' engagement in outdoor activities. Understanding the patterns of residents' utilisation of outdoor spaces and the constraints they face in the cold urban environment is crucial. Despite this, there is currently a lack of systematic reviews synthesizing evidence. This study conducts a systematic literature review from the social ecology perspective, organizing relevant evidence on residents' usage patterns, constraints, and preferences for outdoor spaces in cold urban environments. The literature review spans studies published from 2000 to 2023, drawing data from six electronic databases, including Google Scholar, Web of Science, and Scopus. Ultimately, 31 articles (N = 31) were included in the review. The findings indicate that outdoor spaces in cold urban areas are influenced by a range of factors, encompassing individual, social, physical, and perceptual environmental attributes. Consequently, a conceptual framework based on social ecology is developed to comprehend the usage and constraints of outdoor spaces in cold urban environments. This research provides valuable insights for urban planners and designers in designing and planning outdoor spaces in cold cities.

Ghanaian Institutions and Supply Chain Management Practices: A Systematic Review of Evidence

Ghanaian Institutions and Supply Chain Management Practices: A Systematic Review of Evidence

Physical Activity Interventions in People with Diabetes: A Systematic Review of The Qualitative Evidence.

The aim of this systematic review is to summarize the results of qualitative research into people with type 2 diabetes mellitus (T2DM) and their propensity to engage in physical activity (PA), and to identify and analyse their experiences and opinions of interventions and programs designed to increase their adherence to PA recommendations. Systematic review of qualitative studies extracted from databases using the SPIDER systematic search method. The review included studies that combined qualitative and mixed methods research and compiled the experiences and opinions of people with T2DM who had participated in interventions to increase their levels of PA. A thematic summary of qualitative data was performed. The review comprised nine studies published between 2017 and 2021, which included 170 people. Four themes and ten subthemes were identified. The four themes include: (1) factors related to PA, (2) factors related to the program, (3) factors related to the support the participants received and (4) factors related to the person. The support patients receive, both from family/friends and from health providers, is key to consolidating changes in habits and in promoting individualized health education. Future interventions and health policies should reinforce programs designed to promote PA that prioritize the experiences of people in order to increase their adherence to PA programs.

Metabolic surgery as an intervention for the global epidemic of uncontrolled diabetes: a systematic review of the current evidence and future directions

Metabolic surgery as an intervention for the global epidemic of uncontrolled diabetes: a systematic review of the current evidence and future directions

The impact of Ashtanga yoga on stress management and mental well-being: A systematic review of recent evidence

The impact of Ashtanga yoga on stress management and mental well-being: A systematic review of recent evidence

World Federation of Acupuncture-Moxibustion Societies Clinical Practice Guideline on Acupuncture-Moxibustion: Non-Specific Low Back Pain recommendation summaries: 世界针灸学会联合会《针灸临床实践指南:非特异性腰痛》推荐意见概述

Clinical Practice Guideline on Acupuncture and Moxibustion: Nonspecific low back pain was revised and released by the Standards Working Committee of World Federation of Acupuncture-Moxibustion Societies (WFAS) on October 9, 2023. This is the first clinical practice guideline (CPG) on acupuncture and moxibustion for nonspecific low back pain approved by an international academic organization, which provides the evidence-based recommendations and practical therapeutic protocols for international acupuncture practitioners. This CPG was developed by following Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology, and the Principles of the World Health Organization Handbook for Guideline Development. The guideline development group (GDG) from different countries, with different professions, played a critical role in the formulation of clinical questions, recommendations, and therapeutic protocols. Recommendations are the key content of a CPG and the direct answers to clinical questions. Hence, this article focuses on the recommendations of this CPG. The recommendations were formulated using the modified Delphi method and the GRADE grid rules, based on the updated systematic reviews of clinical evidence. A total of seven recommendations for ten clinical questions were formulated in this CPG, including one conditional recommendation for either the intervention or the comparison based on very low quality of evidence, and six conditional recommendations for the intervention based on very low quality of evidence.

Experiences of patients with metachromatic leukodystrophy, adrenoleukodystrophy, or Krabbe disease and the experiences of their family members: a qualitative systematic review.

This review aimed to synthesize the experiences of patients with metachromatic leukodystrophy, adrenoleukodystrophy, or Krabbe disease and the experiences of their families. Leukodystrophies are metabolic diseases caused by genetic mutations. There are multiple forms of the disease, varying in age of onset and symptoms. The progression of leukodystrophies worsens central nervous system symptoms and significantly affects the lives of patients and their families. Qualitative studies on the experiences of patients with leukodystrophies and their family members were included. These experiences included treatments such as enzyme replacement therapy and hematopoietic stem cell transplantation; effects of tracheostomy and gastrostomy; burdens on the family, coordinating care within the health care system, and family planning due to genetic disorders. This review considered studies in any setting. MEDLINE (Ovid), CINAHL Plus (EBSCOhost), APA PsycINFO (EBSCOhost), Scopus, and MedNar databases were searched on November 18, 2022. Study selection, critical appraisal, data extraction, and data synthesis were conducted in accordance with the JBI methodology for systematic reviews of qualitative evidence, and synthesized findings were evaluated according to the ConQual approach. Eleven studies were eligible for synthesis, and 45 findings were extracted corresponding with participants' voices. Of these findings, 40 were unequivocal and 5 were credible. The diseases in the included studies were metachromatic leukodystrophy and adrenoleukodystrophy; no studies were identified for patients with Krabbe disease and their families. These findings were grouped into 11 categories and integrated into 3 synthesized findings, including i) providing care by family members and health care providers as physical symptoms progress, which relates to the effects of the characteristics of progressive leukodystrophies; ii) building medical teamwork to provide appropriate support services, comprising categories related to the challenges experienced with the health care system for patients with leukodystrophy and their families; and iii) coordinating family functions to accept and cope with the disease, which included categories related to family psychological difficulties and role divisions within the family. According to the ConQual criteria, the second synthesized finding had a low confidence level, and the first and third synthesized findings had a very low confidence level. The synthesized findings of this review provide evidence on the experiences of patients with metachromatic leukodystrophy or adrenoleukodystrophy and their families. These findings indicate that there are challenges in managing a patient's physical condition and coordinating the health care system and family functions. PROSPERO CRD42022318805. A Japanese-language version of the abstract of this review is available [ http://links.lww.com/SRX/A49 ].

Analysis of Factors Affecting Unemployment: A Systematic Literature Review of Evidence From Ethiopia

Analysis of Factors Affecting Unemployment: A Systematic Literature Review of Evidence From Ethiopia

'Throw me a life buoy, please': A systematic review and thematic synthesis of qualitative evidence regarding nurses' experiences of caring for inpatients with borderline personality disorder and/or non-suicidal self-injury.

Non-suicidal self-injury (NSSI) is prevalent in individuals diagnosed with borderline personality disorder (BPD), particularly in inpatient settings. This poses challenges, leading to frustration and powerlessness among healthcare professionals. This, in turn, puts mental health nurses at risk of compassion fatigue (CF), impacting treatment quality. We conducted a systematic review and meta-synthesis to investigate the experiences of mental health nurses caring for people with BPD and/or NSSI in inpatient settings. Literature search was performed in MEDLINE, CINAHL, PsychINFO and Web of Science. The Critical Appraisal Skills Programme (CASP) was used to critically appraise each study. For synthesis of findings from original studies, Thomas and Harden's thematic synthesis was used. In total 1492 studies were screened of which seven met the inclusion criteria. We identified four main analytical themes: 'Notions on nursing', 'Reality calls', 'Fall of ideals' and 'Throw me a lifebuoy, please', with each two subthemes included. Despite nurses' strong motivations for positive change and assistance, unexpected demands lead to emotional exhaustion, affecting their care provision. The study underscores the necessity of addressing nurses' emotional strain through education and skill-oriented training, enhancing their resilience and reducing CF risk, ultimately securing adequate care, and improving patient outcomes.

Does Long-term Surveillance Imaging Improve Survival in Patients Treated for Head and Neck Squamous Cell Carcinoma? A Systematic Review of the Current Evidence.

Long-term post-treatment surveillance imaging algorithms for head and neck squamous cell carcinoma are not standardized due to debates over optimal surveillance strategy and efficacy. Consequently, current guidelines do not provide long-term surveillance imaging recommendations beyond 6 months. We performed a systematic review to evaluate the impact of long-term imaging surveillance (i.e., imaging beyond 6 months following treatment completion) on survival in patients treated definitively for head and neck squamous cell carcinoma. A search was conducted on PubMed, Embase, Scopus, the Cochrane Central Register of Controlled Trials, and Web of Science for English literature published between 2003 and 2024 evaluating the impact of long-term surveillance imaging on survival in patients with head and neck squamous cell carcinoma. 718 abstracts were screened and 95 underwent full-text review, with 2 articles meeting inclusion criteria. The Risk of Bias in Non-randomized Studies of Interventions assessment tool was used. A qualitative assessment without a pooled analysis was performed for the two studies meeting inclusion criteria. No randomized prospective controlled trials were identified. Two retrospective two-arm studies were included comparing long-term surveillance imaging with clinical surveillance and were each rated as having moderate risk of bias. Each study included heterogeneous populations with variable risk profiles and imaging surveillance protocols. Both studies investigated the impact of long-term surveillance imaging on overall survival and came to a different conclusion with one study reporting a survival benefit for long-term surveillance imaging with FDG PET/CT in patients with stage III or IV disease or an oropharyngeal primary tumor and the other study demonstrating no survival benefit. Limited heterogeneous retrospective data available precludes definitive conclusions on the impact of long-term surveillance imaging in head and neck squamous cell carcinoma. There is insufficient quality evidence regarding the impact of long-term surveillance imaging on survival in patients treated definitively for head and neck squamous cell carcinoma. There is a lack of standardized definition of long-term surveillance, variable surveillance protocols, and inconsistencies in results reporting, underscoring the need for a prospective multi-center registry assessing outcomes. HNSCC = Head and Neck Squamous Cell Carcinoma; RT= radiotherapy; NCCN = National Comprehensive Cancer Network; MPC = metachronous primary cancer; CR = complete response; OS = overall survival; CRT = chemoradiotherapy; HPV = human papillomavirus; PFS = progression-free survival; CFU = clinical follow up; NI-RADS = Neck Imaging Reporting and Data System.

The impact of cardiovascular events in bronchiectasis: a systematic review and meta-analysis.

Bronchiectasis is a chronic respiratory condition characterised by airway and systemic inflammation with prevalence increasing with age. Given the median age of the patients, it is common to observe the presence of comorbidities, particularly cardiovascular diseases, which have been linked to adverse clinical outcomes. To investigate the pooled estimates of the association between bronchiectasis and coronary heart disease or stroke within this population, we conducted a systematic review and meta-analysis of the available scientific evidence. Three investigators independently performed the search on PubMed and other sources and included studies published up to October 2023 according to predefined criteria. Relative measures of association between bronchiectasis and cardiovascular events were pooled and meta-analysed using a fixed-effects model. Studies were evaluated using the Newcastle-Ottawa Scale for assessing the quality of non-randomised studies in meta-analyses. A final pool of nine studies was included in the systematic review, with a total of 22 239 patients. Meta-analysis of three high-quality cohort studies showed a pooled hazard ratio of 1.42 (95% CI 1.30-1.57) for coronary heart disease and 1.71 (95% CI 1.55-1.89) for cerebrovascular stroke. The increased cardiovascular risk among people with bronchiectasis underscores the critical need to raise awareness of this association and to develop preventive strategies accordingly. Further translational studies are imperative to gain a deeper understanding of the complex interplay between inflammation, the immune system and endothelial dysfunction in this patient group.